Tighter blood glucose control through medication linked to higher death risk

[ringi]

Insulin is mooted to be one if the culprits of atherosclerosis via inflammation. So type2s a higher risk because of insulin, rather than the meds themselves?
Insulin like meds is whst the study was all about, right?

That's my reading on of it, all the meds that increased insulin did badly when targeting a low BG, the meds that decreased insulin needs did well when targeting a low BG. I expect over the next few years we will hear a lot more about inflammation due to high insulin level being connected to lots of different medical conditions.

 

[Oldvatr]

Remember the inslin levels (both body produced, and injected) in Type2 are often at least 10 times as much as in Type1........

So a T2D using insulin will have a 10x increase in risk? Not sure the stats back that up.

 

[Oldvatr]

That's my reading on of it, all the meds that increased insulin did badly when targeting a low BG, the meds that decreased insulin needs did well when targeting a low BG. I expect over the next few years we will hear a lot more about inflammation due to high insulin level being connected to lots of different medical conditions.

There are other studies that show that T1D fare best on the mid range targets, and do worse on both tight or relaxed control regimes unless taking Metformin as well.

 

[Art Of Flowers]

I will be 65 next April and will qualify for the state pension. I did think of deferring it as they raise it by 1% for every 10 weeks you defer and I will still be in full time employment. However, I think for diabetics it is better to just take the cash because average life expectancy for type 2 diabetics is only about 77.

The biggest factor for diabetic mortality is heart disease and strokes. Another thing which concerns me is the increased likelihood of getting dementia. Both heart disease and dementia are related to glucose spikes and high levels of insulin.

Most type 2 diabetics have insulin resistance and I assume I am in this group. This is the reason I was obese and by reducing carbs I have lost 15 Kg, mostly visceral fat around my waist. I still have a few more Kg to lose to have a BMI of 25 and hopefully I have cleared most of the fat around my pancreas. I may need to do some intermittent fasting as a final push to burn off this remaining fat.

There is a concern that my Beta cells may give out over time and I may need other medications. In the meantime I am relying on a LCHF diet and intermittent fasting as the best way to treat my type 2 diabetes as it results in low blood sugars and low insulin.

 

[Oldvatr]

I will be 65 next April and will qualify for the state pension. I did think of deferring it as they raise it by 1% for every 10 weeks you defer and I will still be in full time employment. However, I think for diabetics it is better to just take the cash because average life expectancy for type 2 diabetics is only about 77.

The biggest factor for diabetic mortality is heart disease and strokes. Another thing which concerns me is the increased likelihood of getting dementia. Both heart disease and dementia are related to glucose spikes and high levels of insulin.

Most type 2 diabetics have insulin resistance and I assume I am in this group. This is the reason I was obese and by reducing carbs I have lost 15 Kg, mostly visceral fat around my waist. I still have a few more Kg to lose to have a BMI of 25 and hopefully I have cleared most of the fat around my pancreas. I may need to do some intermittent fasting as a final push to burn off this remaining fat.

There is a concern that my Beta cells may give out over time and I may need other medications. In the meantime I am relying on a LCHF diet and intermittent fasting as the best way to treat my type 2 diabetes as it results in low blood sugars and low insulin.

Sounds like a good plan there. You are quite well grounded in your appraisal of the techniques open to you, and I hope you exceed your expectations.

 

[ickihun]

So a T2D using insulin will have a 10x increase in risk? Not sure the stats back that up.

I agree. My calcium score was only 19 thou @ringi so not much inflammation and blood test backed it up. On large basal units still.

Considering my then 13sts overweight i was encouraged to keep exercising. Not weight loss directly but cardiologist did know i was on bariatric surgery programme, because i reminded him.

I huge weight off my mind that angiogram after calcium score scan.

 

[Alexandra100]

I will be 65 next April and will qualify for the state pension. I did think of deferring it as they raise it by 1% for every 10 weeks you defer and I will still be in full time employment. However, I think for diabetics it is better to just take the cash because average life expectancy for type 2 diabetics is only about 77.

The biggest factor for diabetic mortality is heart disease and strokes. Another thing which concerns me is the increased likelihood of getting dementia. Both heart disease and dementia are related to glucose spikes and high levels of insulin.

Most type 2 diabetics have insulin resistance and I assume I am in this group. This is the reason I was obese and by reducing carbs I have lost 15 Kg, mostly visceral fat around my waist. I still have a few more Kg to lose to have a BMI of 25 and hopefully I have cleared most of the fat around my pancreas. I may need to do some intermittent fasting as a final push to burn off this remaining fat.

There is a concern that my Beta cells may give out over time and I may need other medications. In the meantime I am relying on a LCHF diet and intermittent fasting as the best way to treat my type 2 diabetes as it results in low blood sugars and low insulin.

By your efforts you have raised your life expectancy above the average. Well done!

 

[ickihun]

I will be 65 next April and will qualify for the state pension. I did think of deferring it as they raise it by 1% for every 10 weeks you defer and I will still be in full time employment. However, I think for diabetics it is better to just take the cash because average life expectancy for type 2 diabetics is only about 77.

The biggest factor for diabetic mortality is heart disease and strokes. Another thing which concerns me is the increased likelihood of getting dementia. Both heart disease and dementia are related to glucose spikes and high levels of insulin.

Most type 2 diabetics have insulin resistance and I assume I am in this group. This is the reason I was obese and by reducing carbs I have lost 15 Kg, mostly visceral fat around my waist. I still have a few more Kg to lose to have a BMI of 25 and hopefully I have cleared most of the fat around my pancreas. I may need to do some intermittent fasting as a final push to burn off this remaining fat.

There is a concern that my Beta cells may give out over time and I may need other medications. In the meantime I am relying on a LCHF diet and intermittent fasting as the best way to treat my type 2 diabetes as it results in low blood sugars and low insulin.

I'll be delighted to get to 77. Nearly died a few times already and only 46yrs old. 70s would be a huge huge achievement for me.
I understand we are all different thou.

 

[Biggles2]

There is a concern that my Beta cells may give out over time and I may need other medications. In the meantime I am relying on a LCHF diet and intermittent fasting as the best way to treat my type 2 diabetes as it results in low blood sugars and low insulin.

Your plan is my plan @Art Of Flowers - we can only do the best that we can do with the knowledge available to us and our capacity to stay on track, understanding that our underlying physiology may have other plans for us down the road.
I plan to take an actuarial approach to retirement decision-making also, so I plan to retire at retirement age rather than later. It just makes more sense to me (and for me).
Thanks for your post; the support/guidance/encouragement on this forum is just wonderful!

 

[Alexandra100]

I'll be delighted to get to 77. Nearly died a few times already and only 46yrs old. 70s would be a huge huge achievement for me.
I understand we are all different thou.

Every day your life expectancy goes up, as you learn to look after yourelf better and better, and at the same time medical knowledge improves.

 

[Member34835]

So this is observational thus leading to more questions than answers If you are tyoe 2 and need insulin stimulating meds or insulin does that not mean your diabetes is very progressed and therefore you are more ill and moee at risk of the co morbidities?

 

[Oldvatr]

So this is observational thus leading to more questions than answers If you are tyoe 2 and need insulin stimulating meds or insulin does that not mean your diabetes is very progressed and therefore you are more ill and moee at risk of the co morbidities?

You may be correct on that, but the point I was trying to make is that there seems to be no causal link between the use of insulin itself, and an early death associated directly from that treatment, except for overdose leading to hypo. There does not seem to be any statistical significance between T1D and T2D lifespans that is decreased by using insulin (i.e. that is dose dependant) There could be something involving an insulin incretin medication (for other reasons) but the study does not explore that avenue.

 

[Alexandra100]

So this is observational thus leading to more questions than answers If you are tyoe 2 and need insulin stimulating meds or insulin does that not mean your diabetes is very progressed and therefore you are more ill and moee at risk of the co morbidities?

You might have advanced diabetes OR you might have an enlightened doctor like Dr Bernstein who prescribes small doses of insulin for his patients to help them keep their post prandial blood sugars as low as possible and preserve their beta cells as long as possible. Or, perhaps more likely, neither of these, you just have the usual not very clued-up doctor who is not necesssarily prescribing the most appropriate treatment for you. Sorry!

 

[ringi]

There are other studies that show that T1D fare best on the mid range targets, and do worse on both tight or relaxed control regimes unless taking Metformin as well.

Shame there are not studies of T2 doing low carb, I expectthey will be best on tight control, but don't have solid evidence to back this up. (We also need to remember that lots of people with T1 have given themselves T2 due to cycle of ever increasing carbs and insulin – I think this happens more in the USA then the UK.)

 

[donnellysdogs]

I would liketo know where these 300,000 patients records and evidence was actually gained from... was it surveys? Was it doctors, consultants?

 

[ringi]

There is a national system that gets fed tests results and what drugs people are prescribed etc from GP records unless you have opted out of it.